Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that are found by the Secretary to be likely to assist in promoting the objectives of the Medicaid program. The purpose of these demonstrations, which give states additional flexibility to design and improve their programs, is to demonstrate and evaluate state-specific policy approaches to better serving Medicaid populations.
The U.S. Centers for Medicare and Medicaid Services (CMS) performs a case-by-case review of each proposal to determine whether its stated objectives are aligned with those of Medicaid. CMS also considers whether proposed waiver and/or expenditures authorities are appropriate and consistent with federal policies, including the degree to which they supplant state-only costs for existing programs or services and can and should be supported through other federal and non-Federal funding sources. Generally, section 1115 demonstrations are approved for an initial five-year period and can be extended for up to an additional three to five years, depending on the populations served. States commonly request and receive additional 5-year extension approvals (1).
The Trump administration extended Texas’ waiver right before handing over power. May say that it fills gaps in care that are a result of Texas’ refusal to expand medicaid (2). This was done hastily while Trump was still in office knowing that the Biden administration may not approve a waiver in attempt to push Texas to expand medicaid. Some say Texas is using this waiver to address gaps in insurance coverage instead of expanding (3).
First, explain why you think that Texas should or should not expand Medicaid and what does it mean to “expand.” Next discuss the 1115 waiver in Texas and if you think the Biden administration should reevaluate the previously approved waiver. Discuss this in about 500 words and respond to at least one other post with critical and thoughtful feedback. Be sure to read the three links below. See rubric for more grading details.
1. https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations/index.html (Links to an external site.)
2. https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/#:~:text=The%20ACA%20Medicaid%20expansion%20was,purchase%20coverage%20on%20their%20own (Links to an external site.).
3. https://www.texastribune.org/2021/01/15/texas-1115-waiver-uninsured-low-income/
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